Provider Demographics
NPI:1013011527
Name:SPEARS, BYRON REGINALD JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:REGINALD
Last Name:SPEARS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 S FAIRMOUNT AVE
Mailing Address - Street 2:#203
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105
Mailing Address - Country:US
Mailing Address - Phone:626-792-1344
Mailing Address - Fax:626-792-7033
Practice Address - Street 1:800 S FAIRMOUNT AVE
Practice Address - Street 2:#203
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105
Practice Address - Country:US
Practice Address - Phone:626-792-1344
Practice Address - Fax:626-792-7033
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA 14181122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist